For the breakdown of the harmful amino acid homocysteine (together with vitamin B6 and folic acid)

Elderly people and vegans often have vitamin B12 deficiency

Vitamin B12 deficiency develops as people age when the gastric mucosa erode (atrophic gastritis). As a result, too little of a substance which aids in the absorption of vitamin B12 is formed. To make up for this deficiency the body needs to take in considerably higher amounts of vitamin B12. Veganism, a diet which involves abstaining from not only meat but all animal foods and therefore all foods that contain vitamin B12 such as eggs, cheese or yoghurt, can result in vitamin B12 deficiency if this vitamin is not supplemented.

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Pharmacology

Vitamin B12 is produced and stored primarily in the liver. As a catalyst, Vitamin B12 plays a key role in carbohydrate, lipid, and protein metabolism and protein synthesis. Nerve cell function and the formation of red blood cells (erythropoiesis) in particular are dependent on a good supply of vitamin B12. Vitamin B12 deficiency primarily affects blood-forming tissue, but the nervous system is affected as well, because vitamin B12 is partially responsible for the formation of myelin sheaths in the nervous system. In cases of clinical deficiency, usually due to insufficient absorption of vitamin B12, such as after resection of extensive portions of the small intestine and small intestine irritation (dysbiosis of the intestine), the absorption area is reduced or blocked. This can also occur in diverticulitis, blind-loop syndrome. However, vitamin B12 deficiency may also occur following pharmaceutical treatment with neomycin, colchicine, PAS sodium preparations, and in tapeworm infestation. Intrinsic factor deficiency may occur secondary to diseases of the gastric mucosa and following gastrectomy. Intrinsic factor is essential for the absorption of vitamin B12. Intrinsic factor deficiency is a common cause of vitamin B12 deficiency. After liver reserves have been depleted the following may occur: pernicious anemia, symptomatic psychoses and funicular spinal disease, which initially present in the form of paresthesia with a tingling sensation and poor muscle tone, accompanied by depressed moods. The parenteral administration of Vitamin B12 forte-Hevert injekt can rapidly and permanently eliminate the symptoms of disease caused by vitamin B12 deficiency.

Dosing instructions, method and duration of use

The following instructions for vitamin B12 forte-Hevert injekt apply only if not otherwise prescribed by your doctor. Initially, in the first weeks after diagnosis, 1 ml vitamin B12 forte-Hevert injekt is administered twice a week (equivalent to 1500 μg cyanocobalamin). Anything remaining in the ampoule is discarded. If malabsorption of vitamin B12 in the intestines has been diagnosed, 100 μg cyanocobalamin is subsequently administered once a month.

Componentes

Indications

Vitamin B12 deficiency that cannot be treated with diet. Vitamin B12 deficiency can present with the following clinic pictures: − Hyperchromic macrocytic megaloblastic anemia (pernicious anemia, Biermer’s anemia, Addison’s anemia. All are maturation disorders of red blood cells). −Funicular spinal disease (damage to the spinal cord). Vitamin B12 deficiency confirmed by laboratory tests may occur in cases of − undernourishment and malnutrition for years (e.g., caused by strict vegetarian diet), − malabsorption (insufficient vitamin B12 is absorbed by the intestines) due to − insufficient production of intrinsic factor (a protein that is synthesized in the gastric mucosa and that is needed to absorb vitamin B12), − diseases of the terminal section of the ileum (part of the small intestine), e.g., sprue − Fish tapeworm infestation or − Blind-loop syndrome (change to the course of the intestines following gastric surgery), − congenital Vitamin B12 transport disorders.

Contraindications

Vitamin B12 forte-Hevert injekt is contraindicated in cases of intolerability to any of the ingredients.

Adverse effects

There have been isolated reports of skin symptoms (acne and drug-induced eczema or urticaria) and hypersensitivity symptoms (anaphylactic or anaphylactoid reactions).